title: Noncardiac surgical procedures in patient supported with long-term implantable left ventricular assist device.
abstract: BACKGROUND
  Left ventricular assist devices (LVADs) are increasingly used as bridges to transplantation or as destination therapy. As sicker and older patients are more frequently considered for mechanical support, general surgical problems are expected to increase in these patients.
  
  
  METHODS
  Anesthesia records and clinical charts were reviewed for 11 recipients of LVADs undergoing 12 general surgical procedures between January 1988 and March 2007.
  
  
  RESULTS
  Eight patients underwent major surgical procedures: 1 intracranial hematoma drainage, 1 right hemicolectomy with ileocolostomy, 1 splenectomy, 1 surgical repair of an iliac-femoral artery pseudoaneurysm, 2 cholecystectomies, 1 pyelolithotomy, and 1 coil embolization of a femoral side-branch disruption. Four patients underwent minor surgical procedures. The mean duration of LVAD support before surgery was 58.7 +/- 45.6 days. All patients survived the procedures.
  
  
  CONCLUSIONS
  Noncardiac surgery in LVAD recipients is feasible, without significant morbidity or mortality. Intraoperative coagulation management has a key role in safely performing these procedures.
authors.affiliation: Department of Cardiovascular Disease E. Malan, Policlinico San Donato Hospital, Milan, Italy. agaratti@tiscali.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Garatti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bruschi
authors.forename: Tiziano
authors.initials: T
authors.lastname: Colombo
authors.forename: Claudio
authors.initials: C
authors.lastname: Russo
authors.forename: Filippo
authors.initials: F
authors.lastname: Milazzo
authors.forename: Emanuele
authors.initials: E
authors.lastname: Catena
authors.forename: Marco
authors.initials: M
authors.lastname: Lanfranconi
authors.forename: Ettore
authors.initials: E
authors.lastname: Vitali
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D013997:Time Factors